Physical Therapy after a Hip Replacement

Hip replacements are one of the most commonly performed orthopedic surgeries. Having been performed since 1960, the surgical technique and prosthesis used have been perfected to allow the patient optimal recovery of functioning with less pain. Having the surgery is only half the battle when it comes to the new joint. Physical therapy is the other important aspect in a full and successful recovery.

Following a hip replacement, physical therapy will help to restore the joint motion and strength. Initially therapy begins in the hospital the day after your surgery. The therapist will teach you how to properly move around in bed, get out of bed, get into the shower and car, go up and down a step, and walk with crutches or a walker. There may be some simple exercises you can perform in the bed to help prevent blood clots such as tightening your thighs, buttocks, and moving your ankle.

Following a hip replacement, some patients may do a short stay in a rehab facility for additional therapy before they go home. This usually depends on the age of the patient, functioning when they leave the hospital, additional care from family members at home, and what their home life environment is like (for example, lots of stairs). Some patients may go home after the hospital and have a therapist come to their home. Once the patient is comfortable and strong enough to leave the house, they can begin outpatient therapy.

Outpatient physical therapy will continue to progress the exercises that you began in home therapy. Outpatient facilities offer more options for the patient, such as exercise equipment, and allows them to rehabilitate in a real life setting alongside others that may be recovering from a similar surgery. The focus will be on increasing the range of motion in the new joint as well as strengthening the muscles surrounding the hip. Balance exercises will also be performed to help decrease the risk of falling. Ice or heat may be used in therapy. Heat may be used to warm up a tight muscle and ice may be used after the exercises to reduce swelling and soreness. Your physical therapist will keep in mind any personal goals that you may have, such as returning to golf, to ensure that you perform specific exercises to help you reach that goal.

Following a hip replacement, there are some important considerations that your physical therapist will help you to follow to decrease your risk for dislocating your new hip. If you have the traditional hip replacement from a posterior approach, meaning the incision is along the back of the hip, there are certain motions to avoid. These include not bending the hip past a 90 degree angle, not crossing your leg over the midline of your body (such as crossing your legs), and not allowing the hip to be rotated inward. Some things you can do to follow these precautions are: put a pillow between your knees, use a raised toilet seat, avoid sitting in too low a seat, avoid bending down to tie your shoe, and always make sure your knee caps are pointed forward or slightly out, never inward. Make sure to speak to your doctor or therapist to know what your precautions are since they may be different with certain surgical techniques.

Even though hip replacements are very successful surgeries, the dedication of the patient and the physical therapist will be the key to gaining your most optimal functioning so that you can start enjoying life pain free again.

David Wojick

I had my hip replaced back in 2008. I saw Eileen Polewski in the Glenview Athletico office. She did a wonderful job getting me back to where I wanted. When people ask how long it took to rehab my hip, I tell tell them it depends upon what you want to accomplish and how hard you want to work. A person can be functional within a year. However, if you want to be athletic, it will take a bit more.

It’s also important to get strengthen the muscles in and around the hip prior to surgery. I did a long stint at Athletico Clybourn with Monica prior to surgery and it made a huge difference post surgery. It will make rehabilitation easier and quicker.

Marie Fields

Doctor has said I will eventually have to have hip replacement surgery …. I am 77 years old and would like to know what can be done to reduce the pain without taking medication …. I’m currently taking a series of exercises at Athletico

Liz Hoobchaak

It is great to hear your comments about your positive experiences with therapy after your surgery. The hard work does pay off in the end. In response to what can be done to minimize pain without medication, strengthening your hip muscles as best as you can tolerate will help to keep your hip strong and stable. Although it may be hard if you are experiencing pain, keeping your hip moving with simple range of motion and flexibility exercises will also help. Since you are in therapy already, talk to your therapist about this and see if they can devise a simple home program that you can perform everyday to help keep your hip moble and strong.

treasie craven

I fell down my deck stairs , it had fifteen stairs and I fell head first,damaged my left knee and hurt my back. that was in 2006 and today I am in still severe chronic pain I had knee surgery but my back damaged the l4 and l5 disc in my back, when I went for a 2nd op, the dr said my hip is also have degenerative disc disease and a cyst on the femor head. I need help and am so tired of hurting and living in pain taking all this medication. I/m only 45 and my life stopped i’m in a wheelchair and I hate it .I am looking for a skilled physcian that can help me I will drive wherever to stop this pain even if it ‘s in another state. Please Help me with my search,

Sarah Clough

Thank you for your post! I would be happy to help you in your search. I know some great physicians in the area and have connections with some other great physicians across the country. I am going to send you an email now to follow up with you personally.

james

I wish i knew how important physical therapy was when i got my hip done. I would of pushed my doctor to get me some therapy. I really feel that the reason my hip has not been as successful is because i didn’t have therapy since i was told i was young and would bounce back. now i have to have it re replaced since it is loose. not 100 percent it is because of not having therapy but who knows. it never really seemed to do good.

only reason i am posting this is to say please push your doctors to give you therapy even if they feel you don’t need it.

Since starting out patient Physical therapy 10 weeks from surgery, 3 sessions ago, my hip feels worse. Tremendously painful now. I faithfully did my in home therapy, walking, and stair climbing and was getting better each day. Was walking fast with no limp for 45 minutes last week. Now after three PT exercise sessions, I can hardly walk for the pain in the low back and surgery side of pelvis; The hip extensors and related muscles to my new hip joint. The side leg lifts were fine when I did them in my yoga practice therapy but in PT they seem to have caused injury using more resistance. I’m scared now to do the exercises. Just want to be able to walk, ride bicycle and swim and practice and teach yoga. Should l push through the pain and use a cane again to walk? I don’t think so. I wonder if I should ice and rest a few days. This is what I want to do for the pain. Also so I can work on Monday. I have been icing since my surgery on May 30. Any advice?

rodriquez grambeau

It’s been awhile since your post but since my THR surgery was on Aug 27, 2014 my responses may have been a bit premature at that point.

I am four weeks out from my surgery. About where you were in your post. I hope you used your intuition and cut back on the PT sessions or at least the intensity. Only you can evaluate how your body feels. A good PT can be a wealth of information and a great “cheer leader” but you need to call the shots! You always should have veto power over anything you are doing to your body. Additionally, you should communicate fully your feelings both physical and mental to your PT person. I am doing my own PT guided by my surgeon’s instructions. I add more if it feels doable evaluate and either stay the same or decrease an exercise based on MY bodies response. I walk 2 to 3 miles day on soft ground. Do multiple exercises for mobility, balance and slow strength gains. I ride a stationary bike daily. That’s just what works for me. Everyone is different but if you have had a THR we are similar in that regard. Also, this is no different than any athletic training you have done in the past. You only gain when you are resting! after stressing your body with an increase in activity. So, if you are hurting…listen up! Your body is talking to you. If you are feeling better and doing even a little more…listen up! Your body is telling you that you are on the road to improvement. So, REST when you need it and SLOWLY increase and improve. If your are better every day, why get greedy? Just get better every day. And, of course if you are getting worse…STOP what is making you regress! OK, the rambling is over but just remember to listen to your body! No one else can hear it talking like you can!!
“I am bouncing back….” – Robert Cray Band

Susan

I have a couple of questions, ready soon for the other hip to be replaced, thank you.

I may have to have the hip done while my home is under rehab. So I’m not thrilled with a PT or nurse coming in to see me. Is it acceptable for a disciplined person to do PT on their own at home (with directions provided) until they can get out of the house for PT? Same question for a nurse to check wound, required to check patient at home? Or ok for patient to monitor it themselves? Plan on anterior, front method.

Anterior is supposed to be faster to bounce back from, true? My R hip is being done, I think this may make it harder to get into the drivers seat car? What would be an average time post surg someone w/ an anterior R THR could expect to be able to drive? Any longer than the Left hip? I’m trying to determine how long I’ll be stuck at home.

Bill

Had r hip surgery,rehabed for 3 wks, released from rehab to home & referral to outpatient rehab.After seeing Dr. and getting paperwork to contact rehab of my choice the thought hit me….I wasn’t able to walk unassisted in rehab…I couldn’t stand without falling, Vertigo dizziness standing & sitting. This thought came After…tearing my car seat trying to have wheelchair put in car….How do I get back & forth to therapy when I can’t even stand good? what are drs thinking?

Elizabeth Garry

My mother had a hip replacement three weeks ago. She is 78 years old and doing great . However today was her first outpatient therapy and now five hours later has shooting pain down the side of her leg for the very first time. Up until today she had virtually no pain. Can anyone explain if this is a common occurrence or not?

ellen

My friend just had HR surgery in a Mexico City hospital after an accident broker her hip.
Her doctor told her to wait 6 weeks to begin p.t., altho my friend wants to start soon.
This is very different advice; most American doctors start physical therapy almost immediately after surgery.
Maybe my friend has a special situation, I don’t know.
wonder if anyone knows if this is a different concept in Mexico than here re p.t. after HR. thanks.